Individual
JENNIFER CHRISTINE WICHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-7001
Mailing address
12032 GOLDEN GATE AVE NE, ALBUQUERQUE, NM 87111-5359
(505) 264-0362
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
CNP02203
NM
363LF0000X
Family Nurse Practitioner
CNP 02203
NM
Other
Enumeration date
06/13/2013
Last updated
07/13/2023
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